1. Using the Oregon POLST Registry
For Health Care Professionals

2. What is the Oregon POLST Registry
It is a secure electronic database of POLST orders.
The Registry allows emergency medical professionals treating a patient access to POLST orders if the original POLST form cannot be immediately located.
Non-urgent access is available for those involved in patient care.

3. Submitting Forms to the Registry
Oregon POLST forms signed on or after Dec 3, 2009 are required to be submitted by the form signer (or their designee).
Forms signed prior to Dec 3, can be voluntarily submitted, but should include patient address.
Patients may opt-out of the Registry at any time.

4. Submitting Forms to the Registry
What information is required for a form to be entered into the Registry?
The patient’s full name
The patient’s Date of birth
A legible physician/NP/PA/ND signature*
Date signed
At least one section must be completed for entry into the Registry**
* "Signed" means a physical signature, electronic signature or verbal order documented per standard medical practice. Refer to OAR
**The Registry cannot accept POLST forms marked "Resuscitate" (Section A) and "Comfort Measures Only" (Section B). These orders cannot be interpreted by EMS. Additional information can be found in the Oregon POLST Program's, Guidance for Oregon's Health Care Professionals.

5. Submitting Forms to the Registry
Fax or mail copies of POLST forms (front and back) to the Registry business office with a coversheet from your institution.
Fax:
Mail: 3181 SW Sam Jackson Park Rd
Mail Code BTE234
Portland, OR 97239
Why include a fax coversheet? Forms with missing or illegible information will be faxed back for clarification, and without a coversheet, your organization cannot be “credited” for the submission.

6. Optional Demographic Information
Optional demographics include:
Gender
Address
Last 4 digits of social security number (on forms prior to 2018)
Providing these optional demographics is highly recommended
This information helps expedite patient identification.
Address information allows the Registry to send a confirmation packet directly to the patient.

7. Example Submission Process
Collect
Collect all POLST forms signed that day/week. Please do not send large “batches” of files collected over longer periods as it delays entry and POLST form availability.
Compile optional demographics sheets if applicable.
Verify
Verify that all required elements are present.
Clarify (on the form) any information that may be hard to read.
Submit
Fax or mail to OPR with a coversheet identifying your institution.*
Fax:
Mail: 3181 SW Sam Jackson Park Rd, Mail Code: BTE234, Portland, OR *If you would like a returned list of Registry IDs, include a Registry ID request form.

8. What happens after submission?
Entry
Registry ready forms are entered into the Registry.
Confirmation
A confirmation packet is mailed to the Registrant.
Packet includes a Registry ID magnet and set of stickers (see next slide).
Utilization
Emergency providers call the Registry Hotline if a POLST form cannot be immediately found.
Clinics and support staff call the Registry Business office with non-urgent POLST form requests.

9. Registry ID Magnets and Stickers
Registry ID is the patient’s unique ID in the Registry system
POLST Registry magnets and stickers may be placed in a person’s home and their medical records (example right).
The magnet and stickers are used to alert emergency medical professionals and other health care professionals that the patient has a POLST form on file with the Registry.
POLST Registry magnets and stickers do not replace the original POLST form.

10. The 3 times you should notify the Registry:
A form is updated or a new form is received
A POLST form is revoked or voided
A patient is known to be deceased

11. Need a patient’s POLST?
POLST forms copies can be requested for any patient in your care.
Obtaining a copy of a registered POLST is easy!
Call the Registry business office at
Fax documentation* confirming the patient is in your care.
Forms on file will be faxed to your office within 1 business day.
POLST orders cannot be relayed over the phone
*Forms cannot be released until documentation is received

12. We’re here to help!
Contact the Registry business office for all questions and non- urgent POLST requests.
Phone:
Toll free:
Fax:
Website: